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Left bundle branch area pacing in heart failure: A systematic review and meta-analysis with meta-regression.

التفاصيل البيبلوغرافية
العنوان: Left bundle branch area pacing in heart failure: A systematic review and meta-analysis with meta-regression.
المؤلفون: El Iskandarani M; Department Internal Medicine, Eastern Connecticut Health Network, Manchester, Connecticut, USA., Golamari R; Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, USA., Shatla I; Department of Internal Medicine, Kansas University Medical Center, Kansas City, Kansas, USA., Ujueta F; Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, USA., Mihos CG; Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, USA., Escolar E; Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, USA., Elajami TK; Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, USA., Weiss R; Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, USA.
المصدر: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2024 Aug; Vol. 35 (8), pp. 1536-1547. Date of Electronic Publication: 2024 May 29.
نوع المنشور: Systematic Review; Meta-Analysis; Journal Article
اللغة: English
بيانات الدورية: Publisher: Blackwell Country of Publication: United States NLM ID: 9010756 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8167 (Electronic) Linking ISSN: 10453873 NLM ISO Abbreviation: J Cardiovasc Electrophysiol Subsets: MEDLINE
أسماء مطبوعة: Publication: Malden, MA : Blackwell
Original Publication: Mt. Kisco, N.Y. : Futura Pub., c1990-
مواضيع طبية MeSH: Heart Failure*/physiopathology , Heart Failure*/therapy , Heart Failure*/mortality , Heart Failure*/diagnosis , Bundle-Branch Block*/physiopathology , Bundle-Branch Block*/therapy , Bundle-Branch Block*/diagnosis , Bundle-Branch Block*/mortality , Ventricular Function, Left* , Cardiac Resynchronization Therapy*/mortality , Cardiac Resynchronization Therapy*/adverse effects, Humans ; Treatment Outcome ; Female ; Male ; Aged ; Risk Factors ; Stroke Volume ; Bundle of His/physiopathology ; Middle Aged ; Recovery of Function ; Time Factors ; Heart Rate ; Action Potentials
مستخلص: Introduction: Left bundle branch area pacing is an alternative to biventricular pacing. In this study, we aim to summarize the available evidence on the feasibility, efficacy, and safety of left bundle branch block area pacing (LBBAP).
Objectives: The study summarizes the available evidence on the feasibility, efficacy, and safety of left bundle branch block area pacing (LBBAP).
Background: Cardiac resynchronization therapy (CRT) reduced mortality and hospitalizations in heart failure (HF) patients with a left ventricular ejection fraction (LVEF) ≤ 35% and concomitant LBBB. Recently LBBAP has been studied as a more physiological alternative to achieve CRT.
Method: A search of PubMed, EMBASE, and Cochrane databases were performed to identify studies examining the role of LBBAP for CRT in heart failure. Comprehensive meta-analysis version 4 was used for meta-regression to examine variables that contribute to data heterogeneity.
Result: Eighteen studies, 17 observational and one randomized controlled trial (RCT) were examined. A total of 3906 HF patients who underwent CRT (2036 LBBAP vs. 1870 biventricular pacing [BVP]) were included. LBBAP was performed successfully in 90.4% of patients. Compared to baseline, LBBAP was associated with a reduction in QRS duration (MD: -47.23  ms 95% confidence interval [CI]: -53.45, -41.01), an increase in LVEF (MD: 15.22%, 95% CI: 13.5, 16.94), and a reduction in NYHA class (MD: -1.23, 95% CI: -1.41, -1.05). Compared to BVP, LBBAP was associated with a significant reduction in QRS duration (MD: -20.69 ms, 95% CI: -25.49, -15.88) and improvement in LVEF (MD: 4.78%, 95% CI: 3.30, 6.10). Furthermore, LBBAP was associated with a significant reduction in HF hospitalization (odds ratio [OR]: 0.44, 95% CI: 0.34, 0.56) and all-cause mortality (OR: 0.67, 95% CI: 0.52, 0.86) compared to BVP.
Conclusion: LBBAP was associated with improved ventricular electrical synchrony compared to BVP, as well as better echocardiographic and clinical outcomes.
(© 2024 Wiley Periodicals LLC.)
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فهرسة مساهمة: Keywords: biventricular pacing; cardiac resynchronization therapy; heart failure; left bundle area pacing
تواريخ الأحداث: Date Created: 20240530 Date Completed: 20240802 Latest Revision: 20240802
رمز التحديث: 20240803
DOI: 10.1111/jce.16304
PMID: 38812213
قاعدة البيانات: MEDLINE
الوصف
تدمد:1540-8167
DOI:10.1111/jce.16304